Mid-trimester serum relaxin concentrations and post-partum pelvic floor dysfunction.
OBJECTIVE
To compare mid-trimester serum relaxin concentration (SRC) in primiparous women with or without pelvic floor dysfunction (PFD--stress urinary incontinence (SUI), genital prolapse).


METHODS
Nested observational cohort study.


METHODS
Urogynecology clinic of affiliated University hospital.


METHODS
Primiparous women one to four years post-partum, who had, at time of index pregnancy, participated in a prospective observational study looking at mid-trimester serum relaxin and preterm delivery.


METHODS
Relaxin had been obtained during the index pregnancy at 24 and 28 weeks. Primiparous women who had not given birth to a subsequent child were contacted and asked to return for a single visit assessing pelvic floor function.


METHODS
Pelvic Organ Prolapse Quantification system (POPQ) and Urogenital Distress Inventory (UDI-6).


RESULTS
Fifty women participated, of whom 40 delivered vaginally. Seventeen (34%) women had prolapse and 23 (46%) had stress incontinence. Relaxin was slightly higher (not significantly) in women with PFD than in those without. Relaxin concentration declined significantly more rapidly from 24 to 28 weeks in incontinent women, after adjusting for baseline and obstetrical factors.


CONCLUSIONS
In contrast to previous reports, mid-gestation relaxin tended to be higher and fall significantly faster in women with PFD. Acknowledging relaxin's effects on collagen turnover, our findings explore the association between childbirth and PFD.
Harvey
Marie-Andrée
MA
Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Floor Reconstruction, Kingston General Hospital, and Queen's University, Kingston, Ontario, Canada. harveym@queensu.ca
Johnston
Shawna L
SL
Davies
Gregory A L
GA
D000328:Adult; D001942:Breast Feeding; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D010298:Parity; D017773:Pelvic Floor / Q000503:physiopathology; D049590:Postpartum Period; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D012065:Relaxin / Q000097:blood*; D012307:Risk Factors; D014550:Urinary Incontinence, Stress; D014596:Uterine Prolapse
D012065:Relaxin